You can start good skin care now. Washing with an antibacterial soap twice a day is the first line of defense, and a relatively simple one.

Those of you with simple blackheads and whiteheads will want to use a topical keratolytic medicine, which unblocks the pores (examples include adapalene, or Differin; and topical tretinoin, or Retin-A), plus something that kills bacteria on the surface of the skin (topical clindamycin, benzoyl peroxide, or erythromycin) — a double whammy in the fight against acne. (Topical means that you apply the ointment, cream, or gel directly to the skin. Erythromycin may not work as well, as the bacteria get resistant or outsmart the drug.) For those who have blackheads and whiteheads and want to keep it simple, azeleic acid (brand name Azelex) unblocks the pores and kills bacteria on the surface of the skin. It also helps even out the pigment of the skin so you don’t end up with lighter and darker areas from acne scarring.

More than a few pimples, but not quite a pizza face? You might want to use benzoyl peroxide topically in addition to a different topical antibiotic. The two work better applied together than they would if used individually. You can use over-the-counter or prescription formulations of the former, while your pediatrician or a dermatologist will need to write you a prescription for the latter. For a higher price, there are many combo meds, such as the topical antibiotic clindamycin containing benzoyl peroxide; the best of these call for only one application a day, rather than the standard twice a day. That’s a bonus for those who don’t like much fuss when it comes to face or skin care.

If your acne is bad enough — with blemishes on the face, and perhaps pimples on your back or chest as well — then you might want to use an oral antibiotic (taken by mouth) in addition to the topicals, to kill the bacteria already trapped under the skin. You can be on an antibiotic for years without a problem, although sometimes you have to change to another one if the bacteria that love your skin become smart enough to eventually resist the drug. Girls can use either birth control pill alone, or in conjunction with the antibiotic.

If these strategies don’t work, then you need to talk with your dermatologist about your possibly going on Accutane, which is the pill form of isotretinoin. If you’re a girl and think you might need Accutane, it’s worth trying the birth control pill route first, since Accutane makes periods irregular and also causes birth defects if you get pregnant while taking it (or shortly thereafter). Guys, you’re not off the hook, as the medication can also cause liver damage, making annual blood tests necessary. Before trying Accutane, both girls and guys should have maxed out on whatever topical and oral antibiotics they have used (meaning using all medications faithfully and washing your face twice a day). If that has not cleared up your face in six to eight weeks, then it may be worth pursuing Accutane.

Note: When you make a change in your skin care, especially for acne treatment, it takes about six to eight weeks to see a difference. If your acne regimen isn’t working after that, it’s time to go back to the doctor. There’s a silver lining to all this: Those of you with really oily, pimple-laden faces may actually have fewer wrinkles later in life as compared to your dry-skinned, pimple-free classmates now. Your naturally elevated production of skin oil protects you better against aging and wrinkles.

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YOU: The Owner’s Manual for Teens

A few years ago, we wrote YOU: The Owner’s Manual, which taught people about the inner workings of their bodies—and how to keep them running strong. But you know what? There’s a big difference between an adult’s body and your body, between adults’ health mysteries and your health mysteries, between their questions and your questions. So, teens, this book is for YOU.

Mehmet C. Oz, M.D., is also a New York Times #1 bestselling author and Emmy-award winning host of The Dr. Oz Show. He is professor and vice chairman of surgery at New York Presbyterian-Columbia University and the director of the Heart Institute. He currently lives in Cliffside Park, New Jersey.

5 Comments so far

While I generally believe Dr. Oz is much better than most, if not all doctors I’ve met, and I LOVE his show compared to the other doctor shows for factual information (although I disagree sometimes) – I would just like to bring it to everyone’s attention accutane has been linked to several extremely bad side effects and even death, so I can’t recommend it as it does above. You may escape it as most people do, but there are enough that have been effected to create lawsuits, trust me, its not worth it, for you or the company (laugh). Also, anti-biotics taken orally should only be done if you have a serious health problem as it rarely can cause problems or a resistance (which you may need not to have…).

Thanks, and glad to see the new episodes! I was afraid they took you off air when you told people about apple juice!
please keep doing a good job, but always do better ;)

I took accutane when I was younger and I have to say it changed my life. My skin has been blemish free for the past five years (excluding breakouts due to menstruation hormones). My mother and many of my friends have also taken accutane and I don’t know any one who has had any serious side effects (just mild ones like the super dry skin and chapped lips). Obviously it’s not for everyone and some do experience severe side effects, but from my own person experience, this is a miracle drug.

My only warning is to not take accutane when you are too young. I took it when I was 13 years old and my dermatologist told me if I took it this early, there’s a chance I might have to go back on later in my life. My skin was blemish-free for about five years; however, my acne is beginning to come back and if I am unable to clear it up on my own, I may go back on accutane.

Anyone reading this do not take accutane. I work at a pharmacy and my boss will not even carry the drug because it is so dangerous. Mulitple cases of people taking the drug have resulted in suicide, serious depression, death, and many many other serious factors